Doctor insights on:
Simple Hysterectomy

1

Leaving in cervix:
Some women choose to keep their cervix. The french have done this for years because they think it helps with sex. I have asked patients with cervix and without and both groups report excellent sex life after hysterectomy. Supracervical hysterectomies can be done open, laparoscopically and robotically.
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2

Common:
For an lavh, the laparoscope is used to allow the surgeon to free up the uterus from inside before completing the hysterectomy vaginally. Many surgeons are now using the da vinci robot to complete the surgery completely laparoscopically.
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3

Yes:
The most common reason for leaving the cervix is patient request. Current medical evidence doesn't suggest any advantages to leaving the cervix, though sexual function or bladder function were concerns in the past. If the cervix is left, the uterus must be removed by morcellation which can be a tedious and time-consuming endeavor, especially with a large uterus.
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4

Yes:
The benefit of laparoscopic surgery is a quicker and easier recovery with less pain. The da vinci robot allows even complicated surgeries to be completed laparoscopically avoiding the additional trauma and inherent pain of an open abdominal incision.
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5

Difficult:
This is a difficult one to put into a message, but typically you place 2 to 3 laparoscopic prots, then you ligate and divide the round ligament. Take down the bladder flap surgically. Then separate the ovaries from the uterus. Continue ligating and dividing down to the level of the uterosacral ligaments.
Then proceed vaginally. Enter into the anterior and poste. That's all i get for one msg.
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6

Better than open:
Laparoscopic hysterectomy is performed when vaginal hysterectomy may be very difficult and one wants to avoid a major open surgery. This typically rquires 3 or 4 small incisions in the abdomen. You may go home the same day or stay in the hospital overnight. Your recovery will be significantly faster comapred to abdominal route. Open abdomial hysterectomy is rarely necessary today.
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7

Yes:
Any hysterectomy (removal of the uterus) is considered a major surgery. With that said, there are several different modalities by which a uterus is removed. A lash is a type of laparoscopic hysterectomy in which the uterine body is removed but the cervix is left in the body. It is a simpler surgery with less time spent in the or. Recovery time is typically shorter as well.
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8

Safe and efficient s:
The laparoscope allows excellent visibility inside the abdomen for releasing the uterus (and ovaries as appropriate) before proceeding with the vaginal portion of the hysterectomy. Many studies show fewer complications with lavh compared to an abdominal hysterectomy or a vaginal hysterectomy. There is the additional benefit of inspecting the abdominal cavity before and after the hysterectomy.
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9

LAVH usually better:
Depends on what the reason is, what your body type is and why they are doing it and how good your doctor is at doing lavh. But usually there is less pain and an easier recovery time after lavh. But doing it robotically often has less pain that lavh.
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11

Many causes:
Constipation, intestinal mass, if they left ovaries, then ovarian cyst, abdominal wall mass.
There are many potential causes, i would think your doc will do an ultrasound or ct if they can't figure it out with a pelvic exam.
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12

Individual issue:
It is different for for each woman, very generally if you are a candidate for ablation, it is quicker, easier and less risky and wear and tear on the body. It improves your periods about 90% of the time.
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13

It can:
In many cases yes. If the primary issue is centrally located pain with the menstrual cycle, a hysterectomy is likely to be very helpful. There are also surgical treatments short of a hysterectomy, including resection of endometriosis and pre sacral neurectomy. You need to see a good pelvic pain doctor to help you work out the best option for you.
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16

Same as any surgery:
The risks include bleeding, infection, damage to bowelbladder and adjacent organs, pain , postoperative bleeding, failure to cure pain, scar formation, need for additional surgery. In the case of the lavh - there would be the risk of needing open abdominal surgery as well.
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17

Whole uterus only:
A total (complete) hysterectomy is the removal of the whole uterus(body of the uterus as well as the cervix).A partial (or supracervical) hysterectomy removes part of the uterus and leaves the cervix in place.The removal of the tubes and ovaries is a separate procedure (salpingectomy and oophorectomy respectively). Removing everything is a total hysterectomy and a bilateral salpingo-oophorectomy.
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18

Different ways:
Hysterectomy refers to the uterus and oophorectomy refers to the ovary. They can be removed at the same time vaginally, abdominally, or laparoscopically. Which method is used is determined by your history, condition, and the surgeon's experience.
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19

8 cm is :
Rather large. I am sure your doctor considered risks v. Benefits of the operation. Not likely to be cancer at your age, but not impossible. Follow your doctor's advice. If you don't like with his advice, you can always get a second opinion, but i think it is going to be the same.
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20

That varies:
The specific instruments used will depend on the training and experience of the surgeon as well as the particular requirements based on the patient's anatomy and body habitus. I usually use laparoscopic staples for the internal portion of the surgery and absorbable sutures for the vaginal portion.
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